A New Appliance for Class III Treatment in Growing Patients: Pushing Splints 3

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.

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Quick Correction of a Skeletal Class III Maloclussion in Primary Dentition with Face Mask Plus Rapid Maxillary Expansion Therapy

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.v0i0.32381 ◽

2018 ◽

Vol 20 (2) ◽

pp. 31-37

Author(s):

Hilda Alejandra Bedolla-Gaxiola DDS ◽

David Garrigós-Esparza DDS ◽

Juan Carlos Hernández-Cabanillas DDS, MS ◽

Miguel Ángel Rosales-Berber DDS ◽

Amaury Pozos-Guillén DDS, PhD ◽

...

Keyword(s):

Clinical Signs ◽

Face Mask ◽

Rapid Maxillary Expansion ◽

Primary Dentition ◽

Class Iii ◽

Class Iii Malocclusion ◽

Maxillary Expansion ◽

Orthopedic Treatment ◽

Clockwise Rotation ◽

Skeletal Class

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.

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Evaluation of facial soft tissue thickness in asymmetric mandibular deformities after orthognathic surgery

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-021-00323-5 ◽

2021 ◽

Vol 43 (1) ◽

Author(s):

Luo Huang ◽

Zhicong Li ◽

Jing Yan ◽

Lunqiu Chen ◽

Zheng-guo Piao

Keyword(s):

Soft Tissue ◽

Orthognathic Surgery ◽

Class Iii ◽

Class Iii Malocclusion ◽

Tissue Thickness ◽

Facial Soft Tissue ◽

Thickness Change ◽

Skeletal Class ◽

Soft Tissue Thickness ◽

The Face

Abstract Objectives The purpose of this study was to compare differences in facial soft tissue thickness in three-dimensional (3D) images before and after orthognathic surgery in patients with skeletal Class III malocclusion and to obtain a better understanding of the relationship between hard and soft tissue changes after surgery. Materials and method The present retrospective study included 31 patients with skeletal Class III malocclusion with mandibular chin deviation greater than 4 mm who had undergone cone-beam computed tomography before and 6 months after surgery. Seven bilateral points were established. Measurements were taken from software-generated multiplanar reconstructions. The predictor variables were timing (pre- and postoperatively) and side (deviated vs. nondedicated). A regression model and correlation analysis were conducted for statistical analysis. Results The difference of bilateral facial soft tissue thickness was statistically significantly different between deviated and nondeviated sides (P < 0.05), with lower values observed on the deviated side. The soft tissue thickness has become nearly symmetric at local regions of the lower thirds of the face after orthognathic surgery. However, most measurements showed a negative correlation between changes in soft tissue thickness and changes in bone tissues. Conclusions Skeletal Class III malocclusion with facial asymmetry is accompanied by differences in soft tissue thickness when comparing Dev and N-Dev sides of the posterior region of the mandible, where soft tissues are thinner on the Dev side. Soft tissue thickness can compensate for or camouflage the underlying asymmetric mandible. In addition, the asymmetric soft tissue thickness on the lower third of the face can be partially improved by orthognathic surgery, but the amount of soft tissue thickness change is not consistent with that of hard tissue positional change.

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Combination of expansion and orthognathic surgery in a severe hyperdivergent skeletal Class III malocclusion

APOS Trends in Orthodontics ◽

10.4103/2321-1407.194795 ◽

2016 ◽

Vol 6 ◽

pp. 312-318

Author(s):

Anadha Gujar ◽

M. S. Rani ◽

Sujala G. Durgekar

Keyword(s):

Growth Pattern ◽

Orthognathic Surgery ◽

Class Iii ◽

Class Iii Malocclusion ◽

Maxillary Expansion ◽

Le Fort I Osteotomy ◽

Le Fort ◽

Skeletal Class ◽

Posterior Crossbite ◽

Le Fort I

Class III malocclusions with a severe hyperdivergent growth pattern are very complex to plan and treat. This case report describes the treatment of an adult with a skeletal Class III malocclusion with a midface deficiency, severe bilateral posterior crossbite, and a severe hyperdivergent growth pattern by a combination of a bonded rapid maxillary expansion appliance and surgical procedure of Le Fort I osteotomy for maxillary advancement.

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Sexual dimorphism in the long-term stability (10 years) of skeletal Class III treatment

Progress in Orthodontics ◽

10.1186/s40510-021-00360-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Natalia Tejedor ◽

Conchita Martín ◽

José Antonio Alarcón ◽

María Dolores Oteo-Calatayud ◽

Juan Carlos Palma-Fernández

Keyword(s):

Sexual Dimorphism ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Term Stability ◽

Long Term Stability ◽

Fixed Appliances ◽

Males And Females ◽

Class Iii Treatment

Abstract Background Class III malocclusion is associated with high sexual dimorphism, especially in individuals older than 13 years of age, with significant differences in growth between males and females during the pubertal and postpubertal stages, and in adulthood. The aim of this research was to examine differences between males and females in long-term stability (10 years) of treatment for skeletal Class III malocclusion. Methods Thirty patients (15 males and 15 females) with skeletal Class III malocclusion, who had been treated with rapid maxillary expansion (RME) combined with face mask protraction followed by fixed appliances, were selected sequentially. Thirty patients (15 males and 15 females) with skeletal Class I and mesofacial patterns treated only with fixed appliances for dental problems served as the control group. Differences between groups and sexes were evaluated using lateral cephalograms taken at the start of treatment (T0), immediately after the end of treatment (T1), and after 10 years (T2). The long-term treatment success rate was calculated. Results Ten years after Class III treatment, overjet and overbite relapse occurred similarly in females (− 0.68 ± 0.7 mm; − 0.38 ± 0.75 mm, respectively) and males (− 1.09 ± 1.47 mm; − 0.64 ± 0.9 mm, respectively); the ANB angle and Wits appraisal became significantly more negative in males (− 1.37 ± 1.06°; − 2.7 ± 2.53 mm) than in females (− 0.18 ± 1.26°; − 0.46 ± 1.94 mm). The success rate was 73.3% in males and 80% in females. Conclusions Significant differences in the long-term stability of Class III treatment outcomes have been found between males and females, with a larger skeletal Class III relapse and lower long-term success rates in males.

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Current Trends in Orthognathic Surgery in Poland—A Retrospective Analysis of 124 Cases

Applied Sciences ◽

10.3390/app11146439 ◽

2021 ◽

Vol 11 (14) ◽

pp. 6439

Author(s):

Ewa Zawiślak ◽

Szymon Przywitowski ◽

Anna Olejnik ◽

Hanna Gerber ◽

Paweł Golusiński ◽

...

Keyword(s):

Orthognathic Surgery ◽

Corrective Osteotomy ◽

University Hospital ◽

Class Iii ◽

Facial Skeleton ◽

Skeletal Class ◽

Skeletal Malocclusion ◽

Current Trends ◽

Maxillary Osteotomy ◽

Skeletal Class Ii

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.

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